How to Be the ‘Right’ Kind of Crazy

Take your meds. People who go off their meds are scary and dangerous, and I heard about one of them who went on a rampage. But also, you shouldn’t need your medication to function. Everybody is overmedicated these days and it’s not the Real You ™ once those pills touch your tongue.

It’s really irritating to have to put up with your weird requests and boundaries and all that attention you need. But tell us what we can do to help you!

Think positive. Keep thinking positive. Are you thinking positive thoughts? What about now?

It’s really important that you get treatment, but isn’t, like, everybody mentally ill these days?

Definitely don’t have problems with substance abuse, because at that point it’s all a lack of willpower.

Make sure you have a disorder that’s commonplace enough for us to recognize it, but not too common–that’s the stuff everybody has these days, and it’s probably because the [internet/technology/schools] are causing it.

Have more? Add them in the comments.

Grouchy Kate will go on hiatus beginning tomorrow–I’ll be back to normal blogging.

Take your meds. People who go off their meds are scary and dangerous, and I heard about one of them who went on a rampage. But also, you shouldn’t need your medication to function. Everybody is overmedicated these days and it’s not the Real You ™ once those pills touch your tongue.</blockquote

Oh, of course. The proper liberal skeptic finds the answer right there in the middle.

What’s important is to place yourself in the Sensible Center, as ridiculous as that will look in 50 or 5 years, and as callous as it appears now from the perspective of reasoned and evidence-based (i.e., real) compassion.

Take your meds. People who go off their meds are scary and dangerous, and I heard about one of them who went on a rampage. But also, you shouldn’t need your medication to function. Everybody is overmedicated these days and it’s not the Real You ™ once those pills touch your tongue.

Oh, of course. The proper liberal skeptic finds the answer right there in the middle.

What’s important is to place yourself in the Sensible Center, as ridiculous as that will look in 50 or 5 years, and as callous as it appears now from the perspective of reasoned and evidence-based (i.e., real) compassion.

SC, I think you need a 101 post. Perhaps with an FAQ. Because it comes off as horribly callous lecturing people with a mental illness about how their experience is false.

Here is one example. Without meds, I will (among many other bad things) wake up every day at 4.30 am fantasising about ways of killing myself. With meds, I don’t. So what, exactly, is false here? What I say? The meds are 100% placebo? The meds do something, but the model they are based on is faulty? What?

Take your meds. People who go off their meds are scary and dangerous, and I heard about one of them who went on a rampage. But also, you shouldn’t need your medication to function. Everybody is overmedicated these days and it’s not the Real You ™ once those pills touch your tongue.

How quaint and privileged that you can regard this as a choice.

***

SC, I think you need a 101 post. Perhaps with an FAQ. Because it comes off as horribly callous lecturing people with a mental illness about how their experience is false.

Perhaps you should click over to my blog and read the past few years of posts on the topic. Perhaps you should STFU until you’ve at the very least read and engaged with the materials I linked to in the post linked above.

Here is one example. Without meds, I will (among many other bad things) wake up every day at 4.30 am fantasising about ways of killing myself. With meds, I don’t. So what, exactly, is false here? What I say? The meds are 100% placebo? The meds do something, but the model they are based on is faulty? What?

Read. For the love of everything, for the love of your well being, just read. All of it. (And Erich Fromm.)

SC, the experiences of my family are rather counter to what you are claiming. We mostly have severe ADHD, with some depression and OCD thrown in for good measure, and a side order of schizophrenia (a second cousin) and paranoid delusional (an aunt).

fMRIs show the brains of my family actively shutting down when we concentrate. I sometimes get brain fog so bad that it becomes literally painful to think and can no longer accomplish the most basic of tasks; even putting together a coherent sentence becomes an arduous chore. I was on ritalin for a while, but my body habituated to it and the higher doses were becoming less effective. So for the most part I’ve muddled through on my own. The days where I get the severe brain fog are relatively few between, but I always have problems with becoming distracted and forgetting things. Not that long ago I was administering a medication IV that needed to be done slowly but I had no clock in the isolation ward with me and the dog. So I was trying to count to 30 between pushes of the plunger. I kept reaching about 12 and my brain basically turned off. I’d ‘wake up’ a while later, with no idea how much time had passed. It ended up taking me 25 minutes to administer a medication that should have been over a 10 minute span.

I want to get back on the medication I found that worked… but I keep forgetting to make an appointment. It’s too late for me to call now to make such an appt, and in the morning I will probably forget that I made this comment.

I, personally, am really really tired of being told I’m “living in the past” when I tell the stories that shaped me most, or when I tell my happiest memories, or when I in general just try to give people as much backstory about me as I can because I want to share that with them, since to me… that story IS me. I’m trying to share myself with someone, and they’re telling me to stop focusing on those stories.

They’ll say things like “but you’re here now, tell me about you in the moment!”

“Well in the past I was given a name, but if we’re defining based on what I am solely in this moment: Hi, I’m Really Uncomfortable.”

Honestly… I really don’t resent the people who make these statements. But the statements themselves often make me uncomfortable enough that I don’t want to be around that person anymore, for fear it will just turn into another discussion about what they think I should be doing, and me having to argue with them (when I’m much too tired to do so) that I am already perfectly aware that what they’re suggesting is not going to help and will just make me more tired.

I wish instead of constantly being told not to live in the past, someone could help my present be a little less dull and lonely and tiresome, so good memories wouldn’t seem like all I have sometimes.

There’s a lot more than just a middle ground between “take your meds, people who don’t are scary” and “everyone should be able to function well without meds.” Yes, there’s “taking your meds is the only way you’ll do better, so do it” but there’s also, among other possibilities, “take your meds and you’ll do better,” “take your meds and maybe you’ll do better,” “the evidence is slim that meds generally work, but there’s some reason to believe that they sometimes work, so why not give it a shot,” “meds don’t do anything much beyond what a placebo does, but that’s no reason to stop making other efforts to improve your mental well being,” and, of course, “most mental illness is far scarier for the patient than for anyone else, so do what you can, hope for the best, and fuck the assholes who want to stigmatize you.”

I am concerned that the subtext of your position can lead to victim blaming. In other words, you (“mental illness” sufferer) aren’t really sick, you are just weak, so you do what weak people do – take drugs to cope. Get your sh%t together and go see Dr. Freud to work it out!

Isn’t that what you are saying?

I would characterize biopsychiatry as crude rather than “false”. The problem I think is that we are dealing with an incredibly complex system (the human brain). Because of this complexity we end up with a wide range of causal factors mapping into similar clusters of observables (i.e. symptoms). The observables are like the output of a one-way function in cryptography. This makes it virtually impossible to start with the observables and work backwards to the actual causal factors which produced them.
Because of this one-way function problem, I believe you end up with very different illnesses (i.e. underlying causal factors) being categorized as the same thing. This is because our only choice with mental health problems is to categorize by symptoms; the one-way function problem keeps us from being able to get at the underlying pathology which produced those symptoms. The underlying pathology is hidden in the complexity of the brain.

This lack of insight into underlying causes leaves mental health practitioners stuck with a very crude set of tools that they fumble around in the dark with hoping to find a combination that provides the patient with relief from their suffering. Because of the “trial and error” nature of these tools, there is no guarantee that a treatment which does produce positive results (relief from suffering) is the best treatment. This I think is especially true of psycho-pharmacological treatments.

I think when making a judgement between using psycho-active drugs and using some sort of talk therapy or behavior modification, etc you are stuck trying to guess whether or not the solution is within the reach of the patient or whether the problem is some sort of entrenched pathology that can only be remedied (or mitigated) with a psycho-pharmacological approach. This is the essence of the one-way function problem.

By the way, I say all this not as an detached observer, but as someone who struggles with my own dependence on the psycho-pharmacological solution with all the inherent (but in my case manageable) side effects (as well as uncertainties over long-term effects) versus the drug-free talk-therapy only hell that brought me to that dependence.

I chose what I see as the lesser of evils. What I have is not perfect, but it is in my opinion better than being dead which is a solution which several of my close family members chose to pursue (no thanks).

SC, you say “go read my years of posts” – exactly the problem. You need an introduction, or no-one will know where to start. I was being generous to you by suggesting that. You’re seriously not coming across well; you sound like a crank. You won’t even answer a question, it’s just link link link linkspam link link. And the one link that you say “read” about does not even remotely begin to answer my question, or WMDKitty’s, or rowanvt’s. It’s just a bald assertion, with more links to follow. This is exactly why I say you need a 101 & FAQ.

You assert that psychiatric diagnoses lack validity. Again, how exactly? Specify your terms, make your argument. Links are useful for reference, not as a substitute for argument.

I think I’ve got another one: If anyone on the internet insists that you have some kind of false consciousness as a person suffering from mental illness, definitely rush to read the entire archives of their blog before you attempt to even discuss their ideas with them. Unless you do this, you will remain so underinformed about the conditions you’ve been managing for your entire life, that the blogger will be tragically unable to even have a discussion with your ignorant ass. Certainly be willing to reject your personal experiences with your illness and rethink your entire diagnosis and treatment plan, as this person’s blog (and Erich Fromm) are a much better judge of what’s going on with your mental health than you or your doctors.

*Don’t be a teenager, because then you’re just doing it for the attention. Everyone knows kids don’t have real problems.
*Phobias and anxiety can be cured by just toughing it out! If you can’t tough it out, you’re a baby!

Really? The arguments and evidence in Mad in America? The Myth of the Chemical Cure? The Emperor’s New Drugs? Crazy Like Us? Shyness? Fromm’s work? The two articles by Marcia Angell? The recent public statement of the British clinical psychologists? The Critical Psychiatry Network? The Hearing Voices Network? The recent public admissions by Thomas Insel and David Kupfer? The statements of the UN Special Rapporteur on Torture? This article by Brett Deacon (including the statements presented in Table 2)? You’ve engaged with all of it, and it’s all bullshit?

SC, you say “go read my years of posts” – exactly the problem. You need an introduction, or no-one will know where to start.

The hell? The link I provided above provides a short list of sources. That’s where to start. I was referring to my years of posts in response to the specific comment about my allegedly denying people’s lived experiences. That’s plainly false, as you would know if you’d red my writing about it.

I was being generous to you by suggesting that. You’re seriously not coming across well; you sound like a crank. You won’t even answer a question, it’s just link link link linkspam link link.

Right – it’s the cranks who provide links to extensive citations and evidence.

And the one link that you say “read” about does not even remotely begin to answer my question, or WMDKitty’s, or rowanvt’s. It’s just a bald assertion, with more links to follow. This is exactly why I say you need a 101 & FAQ.

You obviously didn’t read the entire post. But how is this supposed to be a proper attitude for a skeptical thinker – refusing even to be spoonfed information?

You assert that psychiatric diagnoses lack validity. Again, how exactly? Specify your terms, make your argument. Links are useful for reference, not as a substitute for argument.

If you don’t know what scientific validity is, you probably shouldn’t be commenting on a scientific subject. I’ll point out once again that the heads of the NIMH and the APA stated publicly last month that the diagnoses lack validity. Stop going after me long enough to try to appreciate the import of this.

SC,
I read a few posts on your blog, including those that you recommended earlier. They look to me like rants plus a bunch of links to books that allegedly say something that you want your audience to know, but without even stating their main arguments or a rough summary of their content. The “admissions” of not-working seem to be perfect examples of statements that are commented and completely re-interpreted and claimed to be saying the opposite of what they most likely were intended to mean.
This is not “spoon-feeding information”. It’s not even references (which would be the supporting sources for claims in an argument you actually make instead of just omit), it’s just naked claims and links. On the other hand, this style is disturbingly similar to anti-vax, anti-fluoride and similar we-hate-this-horrible-medicine-conspiracy wake-up-sheeple propaganda.
Seriously, if you want to convince people, spelling out your actual coherent argument against “biopsychiatry”, maybe even including your favourite alternative hypothesis to the biological approach to mental illness, would have a way better chance to make an impact.

Oh, no. We’ve lost the Very Important Penis! How will we manage our troubles without His Wisdom to guide us? Surely we shall follow Him all the days of our lives, because He has a Holy Book he can point at! I’m so glad I’ve finally found The True Atheism.

*defiantly takes her fucking meds anyway, you asswiping; and be glad, for without them she can be verily unwise to approach for the terminally un-self-aware*

I get this a lot: ‘You should try this diet/supplement/exercise and stop eating gluten, according to this natural health magazine. You haven’t tried this yet!’ Or just how I should exercise more (yes, yes I should, but) and that should totally substitute for meds.

And apparently, I’d better never suffer a financial catastrophe because I’d just be anathema to some of my family. I’m told to stay away from those destitute and homeless-looking people in public places – they might be (*whispers*) mentally ill. Now there’s an awkward conversation… Granted, there’s also plain classism and fear of homeless people in there.

(I’ll shill for Neuroskeptic’s blog a bit – there are some really informative posts on psychiatry and psychology, often with the attitude expressed by neuroturtle. Also, it’s fun to read.)

i like being told to “just stop doing *insert behavior caused by mental disorder*.” as if doing so would make me less crazy. no, it just makes those around me more comfortable. theres a reason “compulsive” is in the label, people.

It’s important to be the right level of crazy. Slightly off is fine: a few weeks of therapy, a couple months of meds, and you’re all better! Totally bats is fine: lock you up in a mental ward and don’t have to think about you again! Too depressed or socially anxious to make 50 calls to insurance companies, psych*ists offices, and who knows who else, but not depressed enough to be involuntarily held? Tough shit!

And it’s important to have the right disease. Anorexia is the acceptable eating disorder. Bulimia is iffy, but a few afterschool movies have been made about it, so we’ll accept it for now. But binge eating disorder? That’s not a real thing! You’re just fat! Have more willpower! Have you considered dieting and exercise?

And live in the right place too. Where I live, you can’t have an eating disorder, because no one within 100 miles treats eating disorders. It would be a bad idea to have schizophrenia. Have depression instead! And don’t even think about having multiple disorders, because you need to get a big city specialist to deal with that.

One of my nervous habits (and also just plain habits because it's comfortable to me) is to sort of use my nails to dig under each other a little… not painfully, just kind of sliding them under each other. I've had so many people swat my hands or grab them in attempts to "help me stop," and it's like… "I'm sorry this bothers you, or that it's weird or whatever, but this makes me comfortable. Also why the hell are you grabbing me without my permission DO YOU REALLY THINK THAT'S GOING TO HELP MY ANXIETY"

People just need to stop telling people what to do with their own bodies unless they are trained to do so. Slut shaming, prude shaming, how much a person eats, if they dress comfortably instead of "pretty," if they paint their toenails weird colors, if they have weird tics, if they get tattoos, WHATEVER. It all. needs. to stop. And I love you for saying so.

This is based on my experiences on a debate/get to know each other, poorly moderated message board. Some self-proclaimed progressives literally used my history of mental illness as the reason they thought my points were stupid. The board contents are private, so you can’t see them here, but it’s at americanwx.com

While Thomas Szasz doesn’t appear to be a Scientologist (he has repudiated their beliefs), he does appear to be associated with them via the CCHR:

Well I got affiliated with an organisation long after I was established as a critic of psychiatry, called Citizens Commission for Human Rights, because they were then the only organisation and they still are the only organisation who had money and had some access to lawyers and were active in trying to free mental patients who were incarcerated in mental hospitals with whom there was nothing wrong, who had committed no crimes, who wanted to get out of the hospital. And that to me was a very worthwhile cause; it’s still a very worthwhile cause. I no more believe in their religion or their beliefs than I believe in the beliefs of any other religion. I am an atheist, I don’t believe in Christianity, in Judaism, in Islam, in Buddhism and I don’t believe in Scientology. I have nothing to do with Scientology.[35]”

Szasz’s beliefs strike me as the most extreme and as more philosophical than scientific. OTOH the links by Brett Deacon and Marcia Angell that “Salty Current” provided are worth reading. I wouldn’t go so far as to declare that biopsychiatry is “false” as did SC, but these articles do raise some legitimate questions about the gap between the scientific claims of mainstream psychiatry and the actual scientific evidence which is purported to support those claims. I say this as a consumer of psychiatric medication who depends on it to function.

Yeah… It’s obvious from the studies done with them that, say, SSRIs or anti-psychotics or stimulants etc. have psychoactive effects. They have psychoactive effects that can counter patterns of behavior or thought or feeling that we classify as mental illnesses. While I certainly think we overdetermine deviation from normative behaviors and patterns of thought as inherently problematic to some extent (various mental illnesses would be far less problematic for those of us who suffer from them if a brain that worked in certain ways wasn’t presupposed and necessary for so many of our social institutions), all the evidence I’ve seen suggests that pharmaceuticals CAN be used to treat (or aid in the treatment of) mental illness effectively, and the problem is primarily that we’re dealing with a massively complex system (human brain) impacted by genetics, physical environment, physical history, and social history. Hence, the state of ‘biopsychology’ presently sucks, but that’s a call for far more work in the field, not a call to abandon it entirely because our present models aren’t 100% perfect (I mean, seriously, if that’s the standard, we should abandon all scientific pursuits immediately).

And I say this as someone for whom dozens of psychiatrists, counselors/therapists/psychologists, and various synthesized drug combinations have provided no relief from my symptoms (I have found a drug that has been helping for years now, keeping me relatively stable with no escalation of the amount I use, which seems to be a big concern with drugs with ‘abuse potential’ i.e. that are used recreationally, but it remains banned at the federal level and in a majority of US states). Big Pharma absolutely IS a shady industry (for example, adding an NSAID to your pill to extend patent protection and protect profits at the cost of people’s well-beings and lives in an environment where access to health care is dependent almost exclusively on economic privilege is certainly a dick move) and profit motives trump science all the time (this is true in medicine generally, not just psychiatry/psychology), but none of that actually invalidates all of the good evidence for the (perhaps situational) effectiveness of various psychiatric drugs. ‘Biopsychology’ is not an all-or-nothing proposition (anyone flat-out denying the role of socialization and personal history and extant social norms in mental illness is likewise misguided).
I frequently find myself agreeing with SC around issues of feminism; I find her psychopharmacology denialism unfortunate and distressing.